Comparison of the Spo₂/Fio₂Ratio and the Pao₂/Fio₂Ratio in Patients With Acute Lung Injury or Acute Respiratory Distress Syndrome

Abstract

Introduction: Diagnostic criteria for acute lung injury (ALI) and Acute Respiratory Distress syndrome (ARDS) includes acute onset of disease, chest radiograph demonstrating bilateral pulmonary infiltrates, lack of significant left ventricular dysfunction and Pao2/Fio2 (PF) ratio ≤300 for ALI or ≤200 for ARDS. Recent criteria require invasive arterial sampling. The pulse oximetric saturation Spo2/Fio2 (SF) ratio may be a reliable non-invasive alternative to the PF ratio. Methods: In this cross-sectional study, we enrolled 70 patients with ALI or ARDS who were admitted in Tabriz children’s hospital pediatrics intensive care unit (PICU). Spo2, Fio2, Pao2, charted within 5 minutes of each other and calculated SF and PF were recorded to determine the relationship between SF and PF ratio. SF values were examined as a substitute of PF ratio for diagnosis ARDS and ALI. Results: The relationship between SF and PF ratio was described by the following regression equation: SF=57+0.61 PF (P<0.001). SF ratios of 181 and 235 corresponded of PF ratio 300 and 200. The SF cutoff of 235 had 57% sensitivity and 100% specificity for diagnosis of ALI. The SF cutoff of 181 had 71% sensitivity and 82% specificity for diagnosis of ARDS. Conclusion: SF ratio is a reliable noninvasive surrogate for PF ratio to identify children with ALI or ARDS with the advantage of replacing invasive arterial blood sampling by non-invasive pulse oximetry.

Transcutaneous Oxygen Saturation Accuracy in Critically Ill Children

“…There is a strong association between increasing severity of respiratory diseases and poor pulse oximetry accuracy 3 . Some researchers suggest that SpO 2 /FiO 2 ratios could be employed instead of the PaO 2 /FiO 2 ratio in severity prediction of acute respiratory distress syndrome (ARDS) and acute respiratory failure 11,14,15 . The recent paediatric ARDS definitions incorporate SpO 2 /FiO 2 ratios in severity stratification.…”

Assessing the Surgical Experience to Identify Risk Factors Associated with Severe Retinopathy of Prematurity and Laser Intervention

“…The duration and location of the surgical procedure, the intraoperative fraction of inspired oxygen (FiO2) and SpO2 were obtained from the anesthesia record. To assess respiratory function at the time of surgery, the SpO2/Fi02 (SF) ratio was calculated on each infant from the last recorded values prior to surgery [12]. As there is no severity of illness score for the neonate outside of immediate newborn time period, the SF ratio served as an objective measure of respiratory support and allowed comparison of respiratory illness among surgical infants just prior to the operative procedure.…”

High-Flow Nasal Cannula therapy: A Feasible Treatment in Vulnerable Older COVID-19 Patients on the Wards

“…saturation (SpO2) lower than 92% despite maximum oxygen administration with a non-rebreathing mask (15 liters per minute). To assess the severity of Acute Respiratory Distress Syndrome (ARDS) SpO2/FiO2 ratios were calculated, as it was impossible to collect PO2/FiO2 ratios for all patients and because SpO2/FiO2 can be considered equally sensitive and speci c as compared to PO2/FiO2 ratios [12].…”

“…The median time in days between onset of symptoms and hospital admission was six (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Nearly all patients reported cough (91%) and dyspnea (84%) on admission.…”